Individual
JACOB HUDDLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 ELIZABETH PL, DAYTON, OH 45417-3445
(937) 813-1737
(937) 813-4834
Mailing address
1 ELIZABETH PL, DAYTON, OH 45417-3445
(937) 813-1737
(937) 813-4834
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.183456
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
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Other
Enumeration date
01/11/2022
Last updated
02/06/2023
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